Certain characteristics of police work such as shift work, long work hours, high demands, and traumatic exposures have been associated with increased levels of psychological stress and in some cases with adverse cardiovascular outcomes. An observational study conducted over a period of time can provide more convincing evidence that these workplace stressors lead to development of adverse physiological and psychological health outcomes. Thus, the general objective of this project is to conduct a longitudinal follow-up assessment of approximately 475 police officers for whom baseline data and a protocol infrastructure have already been established. The study will assess police workplace stress by examining physiological and psychological measures of stress and evaluating potential associations of these measures with subclinical markers or early signs of cardiovascular and metabolic disease in a population-based design. Markers of disease include blood pressure; laboratory measurement of lipids, glucose, and insulin; heart rate variability to assess autonomic nervous system function; ultrasound imaging studies to measure carotid artery wall thickness (atherosclerosis) and brachial artery reactivity (endothelial or vascular function); and dual-energy x-ray absorptiometric (DXA) measurement of body fat, lean tissue composition, and bone density. Also to be examined are psychosocial factors known to be detrimental to health such as perceived stress, depression, and hostility, and factors known to be protective (e.g., resiliency and social support). The research findings on the health consequences of stress can be translated into improved prevention practices. Analysis of the complex prospective data acquired from this research may contribute to a better understanding of how exposure to stressors over time may lead to early indicators of cardiovascular and metabolic abnormalities. According to the National Institute for Occupational Safety and Health, the percentage of workers who describe their job as very or extremely stressful can be as high as 40 percent (Stress...At Work; NIOSH Publication No. 99- 101). Given this likelihood that stress is relatively common in the workplace, prevention of adverse health consequences that may be associated with stress could benefit a large proportion of the working population. PUBLIC HEALTH RELEVANCE: Stressors inherent in police work and related lifestyle factors have been associated with adverse cardiovascular and metabolic health outcomes. However, the majority of studies has thus far been cross sectional in design, and has focused mostly on apparent clinical outcomes. Thus, the overall goal of this project is to longitudinally examine the impact of occupational stressors on early signs of cardiovascular and metabolic disease in police officers in order to further knowledge on this topic and enhance prevention efforts in the field.